Mentor-maryland | |
620 West Naylor Mill Road Suite A-f Salisbury MD 21801 | |
(410) 548-5921 | |
Not Available |
Full Name | Mentor-maryland |
---|---|
Speciality | Community/behavioral Health |
Location | 620 West Naylor Mill Road, Salisbury, Maryland |
Authorized Official Name and Position | Carol Ivy Simmons (DIRECTOR, OMHC) |
Authorized Official Contact | 4104554600 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Mentor-maryland 5720 Executive Drive Catonsville MD 21228 Ph: (410) 455-4600 | Mentor-maryland 620 West Naylor Mill Road Suite A-f Salisbury MD 21801 Ph: (410) 548-5921 |
NPI Number | 1750817912 |
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Provider Enumeration Date | 05/10/2017 |
Last Update Date | 05/10/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750817912 | NPI | - | NPPES |
056668 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | MH-1792 (Maryland) | Primary |
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